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RNMH2014

November 30 - December 6, 2014, Hokkaido, Japan

Registration Form: Step 2

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Name and Affiliation

Prof.
Taro
Yamamoto
Kochi Universoty of Technology
test@yahoo.co.jp
General Participant

Contact Information

      

Registration

      
                           
      
Date: Nov. 30th (Sun)
Fee: 5,400 JPY
      
Date: Dec. 5th (Fri)
Fee: 3,200 JPY
      
To: Nibutani Ainu village & museums, day trip by bus from Date City
Date: Dec. 3rd (Wed)
Fee: 3,500 JPY (transportation, admission fee, and meals)
Deadline: September 30th (Tue)
      
To: Shiraoi Ainu Village and Museums, due to arrive at Sapporo (17:00) via Chitose Airport (16:00)
Date: Dec. 6th (Sat)
Fee: 4,500 JPY (transportation, admission fee, and meals)
Deadline: September 30th (Tue)
      

Accompanying person(s)

person(s)
      
1 Family Name:
Given Name(s):
Registration:       
                           
Welcome Banquet:               Nov. 30th (Sun) Fee: 5,400 JPY
Farewell Party:               Dec. 5th (Fri) Fee: 3,200 JPY
Excursion:               Dec. 3rd (Wed) Fee: 3,500 JPY
Post-conference Excursion:               Dec. 6th (Sat) Fee: 4,500 JPY
Dietary Restrictions:       
If Yes,   
2 Family Name:
Given Name(s):
Registration:       
                           
Welcome Banquet:               Nov. 30th (Sun) Fee: 5,400 JPY
Farewell Party:               Dec. 5th (Fri) Fee: 3,200 JPY
Excursion:               Dec. 3rd (Wed) Fee: 3,500 JPY
Post-conference Excursion:               Dec. 6th (Sat) Fee: 4,500 JPY
Dietary Restrictions:       
If Yes,   

Payment


Regular participants will receive a collection of abstracts. They will also be provided with lunch (December 1, 2, 4, and 5) and soft drink (November 30, December 1, 2, 4, and 5) on the days of the conference. Accompanying persons will be provided lunch and soft drink on the days of the conference.
      
If Credit Card, please fill the following.
If Bank Transfer, the details of the account information will be included in the auto-response form; please note that any additional handling fees would be borne by you.
      
(as it appears on the card)

[Note] The charge will appear on your credit card under the name "Quality Management Co., Ltd.". This is one of our authorized proxy companies, in charge of the collection of the conference registration fees.

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